Provider Demographics
NPI:1134774011
Name:UNG, LINDA L (PA-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:UNG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 CENTERVILLE ROAD
Mailing Address - Street 2:STE 102
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2129
Mailing Address - Country:US
Mailing Address - Phone:401-773-7220
Mailing Address - Fax:401-773-7221
Practice Address - Street 1:535 CENTERVILLE ROAD
Practice Address - Street 2:STE 102
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2129
Practice Address - Country:US
Practice Address - Phone:401-773-7220
Practice Address - Fax:401-773-7221
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant